NEW YORK r" . Vii [0/10 state department of NlraV R. Shah, M.D., M.P.H. EALTH Kelly Commissioner Eire-outlive Deputy Commissioner May 16, 2013 CERTIFIED MIL-RE TURN RECEIPT REQUESTED Glen Edward Marin. 13.0. REDACTED Re: License No. 16261? Dear Dr. Marin: Enclosed is a copy of the New York State Board for Professional Medical Conduct (BPMC) Order No. 13-144. This order and any penalty provided therein goes into ciTect May 23. 20l3. Please direct any questions to: Board for Professional Medical Conduct, 90 Church Street, 4th Floor, New York, NY 10007-2919, telephone 212-417-4445. Sincerely. REDACTED Katherine A. Hawkins, M.D., .D. Executive Secretary Board for Professional Medical Conduct Enclosure cc: Douglas Nadjari, Esq. Ruskin Moscou Faltischek, RC. 1425 RXR Plaza East Tower, 15th Floor Uniondale, NY 1 1556?1425 HEALTH.NY.GOV facebookLomINYSDOH NEW YORK STATE DEPARTMENT OF HEALTH STATE BOARD FOR PROFESSIONAL MEDICAL CONDUCT IN THE MATTER OF GLEN EDWARD MARIN, D.O. BPMC N0 . 13- 144 CONSENT ORDER Upon the application of (Respondent) Glen Edward Marin. 0.0.. in the attached Consent Agreement and Order. which is made a part of this Consent Order. it is ORDERED. that the Consent Agreement. and its terms. are adopted and it is further ORDERED. that this Consent Order shall be effective upon issuance by the Board. either by mailing of a copy of this Consent Order. either by ?rst class mail to Respondent at the address in the attached Consent Agreement or by certi?ed mail to Respondent's attorney. OR upon facsimile transmission to Respondent or Respondent's attorney. whichever is ?rst. SO ORDERED. 5/15/2013 REDACTED ARTHUR S. HENGERER. MD. Chair State Board for Professional Medical Conduct NEW YORK STATE DEPARTMENT OF HEALTH STATE BOARD FOR PROIEESSIQHAL MEDICAL 1H . - OF CONSENT GL EDWARDMAFHN DD END - Em . EN ORDER Glen Edward Marin D. O. that all ofthe following statements ara_ true: That on or about July 1 1985 was licensed to pmc?oa nsbopamlc medidne ln the State of New York and Issued License No.162617 by the New YOTK State Education Department. My cum address REDACTED ah: I will advise the Director or the Of?ce of Profasaiona'l'M?ec'l'lcal Conduct of any change Ufaddress. I understand that me New York State Board for Professional Medical Corduct (Board) has charged me with one aped?catlon of pmfasslunal misconduct as set forth In a Statement of Charges. maimed as snatched to and part of Consent Agreement. I agree not to earliest the allegations, in full satisfaction oflha charges against me and agrae to the following penalty: l? - Pursuant to N.Y. Pub. l-leelth Law 2309(9), shell be placed on probation for e'pEFio'tTofihree years. subje'Et?to' lie tonne set forth In e?eciied Emibit "an; I hit-titer agree that the Coneem Order shall lrnpese the ?allowing conditions: ?rst Respondent Shall, In the course of practicing medicine in New York State. examine and treat any female patient only in the presenoe of a chaperone, as is more fully set forth in attached Emiolt This condition shall take oiled 120 days our the Coneem Order?s date and will continue so long as Respondent rename a licensee in New York State; and That Rewondent shell remain In continuous complianoewith all requirements of N.Y. Educ. Law 660; including but-not limited to the requirements that shell register and oon?n ue to be registered with the New York State Education Deparh'nent (except during periods of actual suspension) and hail a licensee shall pay all registration fees. Respondent shall not axemiae the option provided in MY. Educ. Law?g 6502(4) to avoid emanation and payment of fees. This condition shall take effect 120 dove alterthe Consent e?eo?ve dale and will oontinuo so long as Respondent romaine a licensee in New York State; and That Respondent shall remain in continuouecornplienoe with all requirement: of NY. Pub. Health Law 2995-at?4) and 10 N.YC.FLR. 1000.5 . .. . i3- including but not limited'to the requirements that a licensee eheil: report to ?the aspen-ham am physician pro?le for the licensee; continue to notify the department of any change in pro?le information within 30 days ofany change (or in the case of optional information. within 365 days of such change); and, in addition to such periodic reports and noti?cation of any changes, update his or her pro?le infonnation within six months priorto the expiration date ofthe licensee's registration period. shall submit changes to his other physician pro?le information either electronically using the department's sec-me web cite or on tonne prescribed by the department, and licences shell attest to the oompletenue and correctness of any changes licensee submits to the department. This condition snail take effect 30 days after?'le Orders effeodve date and shall continue so long as Respondent remains a lioeme in New York State. Respondent's failure to comply with this condition. if proven and found at a hearing N.Y. Pub. Heeith Law 230. shall constitute misconduct as de?ned in N. Y. Educ. Law 6530(21) and .Y. Educ Law Potential penalties for failure to comply with this condition may include all penalties for professional misconduct set forth' in N.Y. Pub. Health Law 230-; including but not limited to: revocation or euepeneion of Ilcertee. censure and reprimand probation. public service andlor fine; of up to $10 000 per speci?cation of misconduct foundHI-A?h-r-?l . 1-15.: I q. .- That Respondent shall cooperate fully with the Office of Professional Medical its onforooi?i?t'dfih and in its: Investigations of modern concerning Respondent. Respondent shall mpond In a timely manner-to all OPMC requests for wri?nn periodic of Respondents compliance with this Consent Orderl Respondent shall meet with a poison doo?natod by the Director of 0PMC. as dirooiod. Respondent shall roopmd and provide all documents and infonnailon within Respondent's control. as directed. This condition shall take efI'eot upon the Board?s issuance of the Conner-It Order and will oon?nuo so long as Respondent ron'Ialm iloanaad In New York State. I stipulate that my failure to comply with any conditions of this Consent Order shall constitute misconduct as de?ned by N.Y. Educ. Law i agmo that. if i am charged wl?1 professional misconduct in ?xture. this Consont Agroomom and Order shall be admitted into Manor: in that proceeding. i ask the noon: to adopt this Consent Agreement. toms shall bind me or common on admission of any of the ad: of alleged misoonduoi: this Consent Agreement shall not to used against me in any my and shall be kept in strict con?dence: and the Board's denial shall be without prejudice to the pending disciplinary proceeding and the Board's final detarmina?on pursuant to N.Y. Pub. Health Law. I understand that ifiho Board not adopt this Consent Agreement. none of its .. - -L i agree that, if the Board adopts this Consent Agreement, the Chair of the Board shell-issue a tent-ii; regret: that this cement Order." shall take em upon its issuer-toe by the Board. either by mailing of a copy ofthe Consent Order by ?rst ates: mei to me at the address in this Consent Agreement. or to my attorney by certi?ed mail. OR upon facsimile transmission to me or my attorney. whichever' It: ?rst. The Consent OrderI the! agreement and all attached Exhibits shall be public documents with only patient identi?es. If any. redacted. As public docwnenoe they may be posted on the Department?s website. OPMC ehatl report this action to the National Data of 0PM: shall deem appropriate. i emulate that the proposed seno?on and Consent Order are att?'lorized by. HY. Pub. Health Law 230 and zone. and that the Board and onMc have the req'uieite powers to carry out all included terms; i ask the Board to adopt this Consent Agreement of my own free and not under duress. compulsion or restraint. in consideration of the waters to me of the Board's adoption of this Consent Agreement, allowing me to reeolve thie - matter without the venomrtelte and burden: ofa hearing on the merits. knowingly waive my right to contest the Consent Order for which i apply, whether administratively or judicially. i agme to be bound by the Consent Order, and I ask that the Board adapt thle Consent Agreement. I understand and agree that the attorney for the Department. the Director of 0PMC ant;I the Chair of the Board eeoh retain complete dieoretion either to enter into the Bank and the Federation of State Medical Boards, and any other en?tiee that the Director l?k- - ?mum- pt: .2). tuna-r . agreement and Consent Order. based upon my application, or to dacllne to do "an. [further urid?istan" ?gtin?g?afdr?s'??al?e written- I Dri?fali?gamuriica?dn - can limit that dfsom?on The undersigned agree to Reepandent': attached Consent Agmermnt and to its TE: Sig/{3 REDACTED ?f DOUGLAS M. NADJARI. . Atlnmey for Respond DATE: '24 REDACTED .. GERARD A. CABRERA, ESQ. Assadata Conn-l Bureau of Prefesslonal Medical Conduct DATE: ?57 3 REDACTED KEITH ML. SERVIS Director O?ice of Professional Me?iml Conduct penalty terms and mndl?gng,? m- . .. Exhibit NEW YORK STATE DEPARTMENT OF HEALTH STATE BOARD FOR PROFESSIONAL MEDICAL CONDUCT IN THE MATTER STATEMENT OF OF CHARGES GLEN EDWARD MARIN, 0.0. GLEN EDWARD MARIN. D.O.. the Respondent, was authorized to practice medicine in New York State on or about July 1, 1985 by the issuance Of License Number 16261? by the New York State Education Department. FACTUAL ALLEGATIONS A. On or about July 18. 2007'. Respondent. during his examination and treatment of Patient A, engaged in inapprOpriate verbal and/or physical conduct. SPECIFICATION OF CHARGE Respondent is charged with committing professional misconduct as de?ned in NY. Educ. Law 6530(31) by willfully harassing, abusing. or intimidating a patient either physically or verbally, as alleged in the facts of Paragraph A. {r f? DATE: Maazch . 2013 New York. New York REDACTED NEMERSON Deputy Counsel Bureau of Professional Medical Conduct 1) 2) 4) 5) EXHIBIT Terms of Probation Respondent's conduct shall conform to moral and professional standards of conduct and governing law. Any act of professional misconduct by Respondent as de?ned by NY. Educ. Law 6530 or 6531 shall constitute a violation of probation and may subject Respondent to an action pursuant to NY. Pub. Health Law 230(19). Respondent shall maintain active registration of Respondent's license (except during periods of actual suspension) with the New York State Education Department Division of Professional Licensing Services. and shall pay all registration fees. Respondent shall provide the Director. Office of Professional Medical Conduct (OPMC). Riverview Center. 150 Broadway. Suite 355. Albany. New York 12204- 27?9. with the following information, in writing, and ensure that this information is kept current: a full description of Respondent's employment and practice; all professional and residential addresses and telephone numbers within and outside New York State; and all investigations. arrests. charges. convictions or disciplinary actions by any local. state or federal agency. institution or facility. Respondent shall notify OPMC. in writing. within 30 days of any additions to or changes in the required information. Respondent shall cooperate fully with, and respond in a timely manner to. OPMC requests to provide written periodic verification of Respondent's compliance with the terms of this Consent Order. Upon the Director of OPMC's request. Respondent shall meet in person with the Director?s designee. Respondent's failure to pay any monetary penalty by the prescribed date shall subject Respondent to all provisions of law relating to debt collection by New York State. including but not limited to: the imposition of interest. late payment charges and collection fees; referral to the New York State Department of Taxation and Finance for collection; and non-renewal of permits or licenses 1T ax Law 171(27); State Finance Law 18; CPLR 5001; Executive Law 32]. The probation period shall toll when Respondent is not engaged in active medical practice in New York State for a period of 30 consecutive days or more. Respondent shall notify the Director of OPMC. in writing. if Respondent is not currently engaged in. or intends to leave. active medical practice in New York State for a consecutive 30 day period. Reapondent shall then notify the Director again at least 14 days before returning to active practice. Upon Respondent's return to active practice in New York State. the probation period shall resume and Respondent shall ful?ll any unfulfilled probation terms and such additional requirements as the Director may impose as reasonably relate to the matters set forth in Exhibit or as are necessary to protect the public health. The Director of OPMC may review Respondent's professional performance. This review may include but shall not be limited to: a review of office records. patient records. hospital charts. andror electronic records; and interviews with or periodic visits with Respondent and staff at practice locations or OPMC of?ces. Respondent shall adhere to federal and state guidelines and professional standards of care with respect to infection control practices. Reapondent shall ensure education. training and oversight of all of?ce personnel involved in medical care. with respect to these practices. Respondent shall maintain complete and legible medical records that accurately re?ect the evaluation and treatment of patients and contain all information required by State rules and regulations concerning controlled substances. 1D)Respondent shall enroll in and successfully complete a continuing education program in area(s) to be determined by the Director of OPMC. This continuing education program is subject to the Director of OPMC's prior written approval and shall be successfully completed within the ?rst 90 days of the probation period. 11)Respondent shall comply with this Consent Order and all its terms. and shall bear . all associated compliance costs. Upon receiving evidence of noncompliance with. or a violation of. these terms, the Director of OPMC andfor the Board may initiate a violation of probation proceeding. and/or any other such proceeding authorized by law. against Respondent. 2) EXHIBIT Chaperone Condition Respondent shall. in the course of practicing medicine" in New York State, examine and treat any female patient only in the presence of a chaperone. The chaperone shall be a licensed or registered health care professional or other health care worker, shall not be a family member. personal friend, or be in a professional relationship with Respondent which could pose a con?ict with the chaperone's responsibilities. The chaperone shall be preposed by Respondent and subject to the written the approval of the Director of OPMC. Prior to the approval of any individual as chaperone, Respondent shall cause the proposed chaperone to execute and submit to the Director of OPMC an acknowledgment of the chaperone's agreement to undertake all of the responsibilities of the role of chaperone. Said acknowledgment shall be made upon a form provided by and acceptable to the Director. Respondent shall provide the chaperone with a copy of the Order and all of its attachments and shall, without fail. cause the approved chaperone to: a) Report quarterly to OPMC regarding the chaperoning of Respondent?s practice. b) Report within 24 hours any failure of Respondent to comply with the Order, including, but not limited to, any failure by Respondent to have the chaperone present when required, or any inappropriate conduct, whether verbal or physical, by Re5pondent in the presence of any patient. c) Con?rm the chaperone's presence at each and every examination and treatment of a female patient by Respondent, by placing the chaperone's name, title and date in the patient record for each and every visit, and by maintaining a separate log, kept in the chaperone's own possession, listing the patient name and date of visit for each and every patient visit chaperoned. d) Provide copies of the log described in paragraph c, above, to OPMC at least quarterly and also immediately upon the Director?s request,